scholarly journals 10 year institutional experience of use of buccal mucosal grafts for complex urethral reconstruction for varied indications with its outcome

2020 ◽  
Vol 7 (10) ◽  
pp. 3393
Author(s):  
Hemangi R. Athawale ◽  
Shivaji B. Mane ◽  
Taha Daginawala
Keyword(s):  
Success Rate ◽  
Surgical Techniques ◽  
Postoperative Outcome ◽  
Clinical Findings ◽  
Sexual Disorders ◽  
Urethral Reconstruction ◽  
Two Stage ◽  
One Stage ◽  
Buccal Mucosal Graft ◽  
One Stage Reconstruction

Background: The objective of the study was to evaluate long term efficacy and outcome of use of buccal mucosal graft (BMG) for urethral reconstruction in varied urologic conditions in children.Methods: We retrospectively reviewed the medical records of 41 patients from 2009 till 2019 in our institution in which BMG was used for urethral reconstruction. Clinical findings along with surgical techniques used were noted for these patients. Postoperative outcome and complications were evaluated.Results: Mean age was 6.8 years and mean follow up was for 4 years. Out of 41 patients, BMG for substitution urethroplasty was used in 25 cases of hypospadias, 4 cases of urethral stricture, 6 cases of 46 XY disorders of sexual disorders, 4 cases of Y-duplication of urethra, and 2 cases of redo-epispadias repair. 11 patients underwent one stage repairs with a success rate of 63% and 30 patients underwent two stage repair with a success rate of 66%. Analysis and comparison of the outcome in relation to the type of repair, meatal position and number of surgical procedures prior to BMG urethroplasty was statistically insignificant.Conclusions: Buccal mucosa is an ideal graft substitute for urethroplasty. Two stage reconstructions has a slightly higher success rate than one stage reconstruction but the choice of the technique must be based on patients characteristics and on surgeons preference. 

scholarly journals Update in Direct-to-Implant Breast Reconstruction

2019 ◽  
Vol 33 (04) ◽  
pp. 264-269 ◽  
Author(s):  
Aurelia Trisliana Perdanasari ◽  
Amjed Abu-Ghname ◽  
Sarth Raj ◽  
Sebastian J. Winocour ◽  
Rene D. Largo
Keyword(s):  
Postoperative Complications ◽  
Breast Reconstruction ◽  
Two Stage ◽  
Surgical Technology ◽  
One Stage ◽  
One Stage Reconstruction ◽  
Reconstruction Option ◽  
Implant Breast Reconstruction

AbstractImplant-based reconstruction (IBR) remains the most commonly utilized breast reconstruction option for post-mastectomy patients. IBR can be approached as either a one-stage reconstruction or a two-stage reconstruction. Facilitated by improvements in surgical technology and advanced techniques, one-stage reconstruction, also known as direct-to-implant (DTI) reconstruction, involves the insertion of an implant at the time of mastectomy. The decision to pursue either a DTI or a two-stage reconstruction is based on several factors, including the patient's overall health, expected risk of postoperative complications, and associated costs to both the patient and hospital.

scholarly journals Dorsally Placed Buccal Mucosal Graft Urethroplasty in Treatment of Long Urethral Strictures Using One-Stage Transperineal Approach

2014 ◽  
Vol 2014 ◽  
pp. 1-6
Author(s):  
Kamyar Tavakkoli Tabassi ◽  
Alireza Ghoreifi
Keyword(s):  
Success Rate ◽  
Operative Procedure ◽  
Transmitted Disease ◽  
Lichen Sclerosus ◽  
Sexually Transmitted ◽  
One Stage ◽  
Urethral Strictures ◽  
Buccal Mucosal Graft ◽  
The Mean

Objectives. To evaluate the results of one-stage buccal mucosal urethroplasty in treatment of long urethral strictures. Methods. This retrospective study was carried out on 117 patients with long urethral strictures who underwent one-stage transperineal urethroplasty with dorsally placed buccal mucosal grafts (BMG). Success was defined as no need for any intervention during the follow-up period. Results. Among 117 patients with mean age of 39.55±15.98 years, the strictures were located in penile urethra in 46 patients (39.32%), bulbar urethra in 33 (28.20%) and were panurethral in 38 (32.48%). The etiology of the urethral stricture was sexually transmitted disease (STD) in 17 (14.53%), lichen sclerosus in 15 (12.82%), trauma in 15 (12.82%), catheterization in 13 (11.11%), transurethral resection (TUR) in 6 (5.13%), and unknown in 51 (43.59%). The mean length of strictures was 9.31±2.46 centimeters. During the mean followup of 18.9±6.7 months success rate was 93.94% in bulbar strictures, 97.83% in penile strictures, and 84.21% in panurethral strictures (P value: 0.061). Conclusions. The success rate of transperineal urethroplasty with dorsally placed buccal mucosal grafts is equal in different sites of strictures with different etiologies. So reconstruction of long urethral strictures may be safely and effectively performed at a simple single operative procedure using this method of urethroplasty.

Cephalometric and Occlusal outcome in Adults with Unilateral Cleft Lip, Palate, and Alveolus after Two Different Surgical Techniques

2003 ◽  
Vol 40 (3) ◽  
pp. 249-255 ◽  
Author(s):  
Alexander Gaggl ◽  
Matthias Feichtinger ◽  
Günter Schultes ◽  
Gert Santler ◽  
Margit Pichlmaier ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Surgical Techniques ◽  
Single Stage ◽  
Long Term Results ◽  
Two Stage ◽  
Anterior Maxilla ◽  
One Stage ◽  
Cleft Lip Palate ◽  
The One ◽  
Molar Region

Objective To assess differences in the aesthetic and functional long-term results of one-stage and two-stage surgical and orthodontic treatment in patients with cleft lip, palate, and alveolus. Design Sixty adult patients who were operated on as children for unilateral cleft lip, palate, and alveolus were examined. In every patient the lip was closed using Tennison's technique. Thirty patients had soft and hard palate closure in two stages and 30 patients in a single stage. Lateral cephalometric and model analyses were conducted at a mean age of 18.4 years. Results In the model analysis, transverse narrowing was seen in all patients after two-stage operations and in three patients after one-stage operations. The deficit was more severe in the molar region in the two-stage group and nearly similar in the premolar and molar region in the one-stage group. A sagittal deficiency in the anterior maxilla was found in 26 patients after two-stage operations and in 16 patients after one-stage operations. In the lateral cephalometric analysis, the mean sella-nasion-point A angle in the one- and two-stage group was 78.2 degrees and 76.8 degrees, respectively. The ANB angle was normal in both groups. In both groups the inclination of the midface was low. There was a low posterior facial height. Minor scarring was seen in the single-stage group. Conclusion A more severe impairment of growth of the maxilla in the sagittal and frontal plane was observed after two-stage operations on the cleft palate.

One-stage procedure to establish osseointegration: a zero to five years follow-up report

1995 ◽  
Vol 109 (7) ◽  
pp. 593-598 ◽  
Author(s):  
Anders Tjellström ◽  
Gösta Granström
Keyword(s):  
Success Rate ◽  
Hearing Aids ◽  
Mastoid Process ◽  
Case Scenario ◽  
Two Stage ◽  
Worst Case ◽  
One Stage ◽  
The One ◽  
Lost To Follow Up

AbstractA cohort of 214 patients, who were operated on to insert implants in the mastoid process for the retention of bone-anchored hearing aids and auricular prostheses, was followed-up over a five-year period. About half the group were operated on using the conventional two-stage procedure allowing three to four months for osseointegration. In the second group (one-stage group) the skin penetrating coupling was connected at the time of the implant insertion. The success rate for stable implants was found to be the same in both groups. In the one-stage group four out of 161 implants inserted were lost and in the two stage group three out of 120. The cumulative success rate was also found to be the same. A ‘worst case’ table where patients lost to follow-up, patients who died during the study period, and patients who for some reason left the study is also included. The importance of this ‘worst case’ scenario when follow-up data are presented is discussed.

scholarly journals Maxillary Sinus Augmentation Using Deproteinized Bovine Bone (Bio-Oss®) and Impladent® Dental Implant System Part I. Comparison Between One-Stage and Two-Stage Procedure

2002 ◽  
Vol 45 (3) ◽  
pp. 115-118 ◽  
Author(s):  
Samer Kasabah ◽  
Antonín Šimůnek ◽  
Jiří Krug ◽  
Miguel Cevallos Lecaro
Keyword(s):  
Surgical Techniques ◽  
Bovine Bone ◽  
Implant Survival ◽  
Two Stage ◽  
Sinus Augmentation ◽  
One Stage ◽  
Group 2 ◽  
The One ◽  
Implant System ◽  
Deproteinized Bovine Bone

This study was undertaken to compare implant survival after one- or two-stage sinus augmentation. Ninety-two maxillary sinuses in 77 patients were augmented with deproteinized bovine bone (Bio-Oss®). These sinuses were subdivided into two groups: Group 1 (n = 49) was operated on with a one-stage procedure, and Group 2 (n = 43) with a twostage operation. A hundred and eighty-five implants were inserted in these augmented sinuses. Clinical and radiographical evaluations were performed and recorded according to certain criteria. The follow-up period was ranging from 16 to 44 months. Out of the implants inserted using the one-stage procedure, all survived. Two implants failed in the two-stage procedure group (98.91 % implant survival). This study showed that no statistically significance was observed between the two surgical techniques (P<0.05). Therefore, the authors concluded the type of surgical procedure (one- or two-stage) has no effect on implant survival.

scholarly journals Considerations Regarding Age at Surgery and Fistula Incidence Using One- and Two-stage Closure for Cleft Palate

2013 ◽  
Vol 59 (6) ◽  
pp. 302-305 ◽  
Author(s):  
Stoicescu Simona ◽  
Enescu Dm
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Surgical Techniques ◽  
Fistula Formation ◽  
Two Stage ◽  
One Stage ◽  
Age At Surgery ◽  
Cleft Palate Repair ◽  
Palate Repair

Abstract Introduction: Although cleft lip and palate (CLP) is one of the most common congenital malformations, occurring in 1 in 700 live births, there is still no generally accepted treatment protocol. Numerous surgical techniques have been described for cleft palate repair; these techniques can be divided into one-stage (one operation) cleft palate repair and two-stage cleft palate closure. The aim of this study is to present our cleft palate team experience in using the two-stage cleft palate closure and the clinical outcomes in terms of oronasal fistula rate. Material and methods: A retrospective analysis was performed on medical records of 80 patients who underwent palate repair over a five-year period, from 2008 to 2012. All cleft palate patients were incorporated. Information on patient’s gender, cleft type, age at repair, one- or two-stage cleft palate repair were collected and analyzed. Results: Fifty-three (66%) and twenty-seven (34%) patients underwent two-stage and one-stage repair, respectively. According to Veau classification, more than 60% of them were Veau III and IV, associating cleft lip to cleft palate. Fistula occurred in 34% of the two-stage repairs versus 7% of one-stage repairs, with an overall incidence of 24%. Conclusions: Our study has shown that a two-stage cleft palate closure has a higher rate of fistula formation when compared with the one-stage repair. Two-stage repair is the protocol of choice in wide complete cleft lip and palate cases, while one-stage procedure is a good option for cleft palate alone, or some specific cleft lip and palate cases (narrow cleft palate, older age at surgery)

scholarly journals Buccal Mucosal Graft Urethroplasty

2010 ◽  
Vol 10 ◽  
pp. 74-79 ◽  
Author(s):  
Angela M. Arlen ◽  
Charles R. Powell ◽  
Henry T. Hoffman ◽  
Karl J. Kreder
Keyword(s):  
Success Rate ◽  
Single Stage ◽  
Fistula Formation ◽  
Team Approach ◽  
Two Stage ◽  
Recurrent Stricture ◽  
Buccal Mucosal Graft ◽  
Surgeon Experience ◽  
Superficial Wound ◽  
Stricture Recurrence

At our institution, the majority of buccal mucosal graft urethroplasties are performed using a two-team approach with an otolaryngologic surgeon. We report our two-surgeon experience with buccal mucosal grafting for reconstruction of all anterior urethral strictures. Twenty-four men underwent autologous buccal mucosal graft urethroplasty between October 2001 and September 2008 for recurrent urethral stricture disease. Twenty-two underwent a single-stage repair and two underwent a two-stage repair. Medical charts were retrospectively reviewed for demographics, comorbidities, etiology, location and length of stricture, and prior interventions in order to identify predictors of buccal urethroplasty success, defined as no evidence of stricture recurrence. All patients underwent retrograde urethrogram and cystoscopy. Operative and anesthesia times were evaluated. We determined an overall success rate of 83.3% (20 of 24 cases). Mean anesthesia time for single-stage urethroplasty was 155 min and mean operative time was 123 min. One of the two two-stage urethroplasties experienced stricture recurrence (50%). The single-stage buccal graft success rate was 86.4% (19 of 22 cases). Two of the four who developed recurrent stricture disease that required intervention had undergone a previous mesh urethroplasty. Complications developed in four of 24 patients (16.6%), including superficial wound infection (one), superficial wound dehiscence (two), and abscess/fistula formation requiring reoperation (one). The buccal mucosa is an ideal tissue for both single- and two-stage substitution urethroplasty for patients with recurrent stricture disease. Our two-surgeon technique minimizes anesthesia and operative times, and contributes to the overall high success rate and relatively low complication rate.

scholarly journals One-stage Exchange Arthroplasty for Periprosthetic Hip and Knee Joint Infections

2016 ◽  
Vol 10 (1) ◽  
pp. 646-653 ◽  
Author(s):  
Manny Nguyen ◽  
Mohamed Sukeik ◽  
Akos Zahar ◽  
Ikram Nizam ◽  
Fares Sami Haddad
Keyword(s):  
Current Literature ◽  
Joint Infection ◽  
Surgical Techniques ◽  
Infection Rates ◽  
Two Stage ◽  
Joint Replacement Surgery ◽  
One Stage ◽  
Exchange Arthroplasty ◽  
Functional Scores ◽  
Knee Replacements

Background: Periprosthetic joint infection (PJI) is a devastating complication of joint replacement surgery. In an aging population of the developed world, the increasing numbers of hip and knee replacements will inevitably lead to increasing incidence of PJI, carrying with (it) significant patient morbidity and cost to the health care system. Two-stage exchange arthroplasty is currently the gold standard but it is associated with multiple operations, prolonged hospitalization and impaired functionality. One-stage exchange arthroplasty is similar to the two-stage procedure but the interval between removal of the prosthesis and reimplantation of a new one is only a few minutes. It has the theoretical benefits of a single anesthetic, shorter hospitalization, less cost and improved function. Methods: We reviewed the current literature regarding the outcomes of one-stage exchange arthroplasties focusing on re-infection rates and functional outcomes. Results: Current themes around the one-stage exchange procedure include the indications for the procedure, definition of re-infection, surgical techniques used to provide fixation and differences in approach for hip and knee replacements. Conclusion: The current literature on one-stage exchange procedure is promising, with comparable results to two-stage revisions for hips and knees in selected patients. However, there is a great need for a large multi-centred randomized control trial, focusing on re-infection rates and functional scores postoperatively, to provide concrete guidelines in managing this complex condition.

scholarly journals Better defining the optimal management of penile urethral strictures: A retrospective comparison of single-stage vs. two-stage urethroplasty

2019 ◽  
Vol 13 (12) ◽  
Author(s):  
Nathan Y. Hoy ◽  
David W. Chapman ◽  
Keith F. Rourke
Keyword(s):  
Cox Regression ◽  
Surgical Techniques ◽  
Single Stage ◽  
Success Rates ◽  
Two Stage ◽  
Cox Regression Analysis ◽  
Urethral Strictures ◽  
Buccal Mucosal Graft ◽  
Retrospective Comparison ◽  
Lower Complication

Introduction: We aimed to compare single-stage and two-stage urethroplasty techniques for the treatment of penile urethral strictures. Methods: We performed a retrospective review of all penile urethroplasties performed at a single centre between 2003 and 2017. The primary outcome was urethral patency, defined as the ability to easily pass a 16 Fr flexible cystoscope at six and 18 months of followup, and development of 90-day complications. Results: Overall, 101 single-stage procedures (48 buccal mucosal graft [BMG] and 53 penile fasciocutaneous flap [PFF])and 53 two-stage procedures were performed. There was no difference in median stricture length between groups (p=0.25). Cox regression analysis did not identify stricture etiology, length, age, obesity, prior reconstruction, or urethroplasty technique to be associated with failure. Log-rank testing did not demonstrate a difference in success rates between surgical techniques (91% [48/53] PFF vs. 83% [40/48] BMG vs. 87% two-stage [46/53]). Thirty-nine percent (60/154) of patients experienced a complication (51% [27/53] PFF vs. 29% [14/48] BMG vs. 36% [19/53] two-stage). Multivariate analysis found urethroplasty technique to be the only factor associated with development of complication (p=0.02); odds ratio relative to BMG was 3.1 (p=0.009) for PFF and 1.4 (p=0.43) for two-stage. Conclusions: There appears to be little difference in success between penile urethroplasty techniques. The shift in technique to a single-stage BMG, when appropriate, appears to be founded on the basis of fewer operations for the patient, relative to a two-stage repair, and a lower complication profile, relative to single-stage PFF, without compromising success rates.

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